Barbieri Robert L, Sluss Pat M, Powers Robert D, McShane Patricia M, Vitonis Allison, Ginsburg Elizabeth, Cramer Daniel C
Ob-Gyn Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Fertil Steril. 2005 Feb;83(2):302-8. doi: 10.1016/j.fertnstert.2004.07.956.
[1] To examine the effects of body mass index (BMI), age, cigarette smoking, cause of infertility, and use of oral contraceptives on baseline serum testosterone (T), and [2] to examine associations between baseline serum T and IVF outcomes such as pre-hCG serum E(2), number of oocytes retrieved, oocyte fertilization rate, and pregnancy outcome in regularly cycling women.
Prospective, cohort study.
Three IVF programs in eastern Massachusetts.
PATIENT(S): Four hundred twenty-five regularly cycling women planning to undergo IVF. Women with polycystic ovary syndrome, ovulatory infertility, or irregular cycles were excluded from this study.
INTERVENTION(S): Collection of epidemiological data and baseline serum in women undergoing IVF.
MAIN OUTCOME MEASURE(S): Baseline serum total T, sex hormone binding globulin (SHBG), and calculation of free androgen index.
RESULT(S): Body mass index >26 kg/m(2) was associated with a significant increase in serum T (P<.01) and free androgen index (P<.0001). Serum T decreased significantly throughout the fourth decade of life (P<.03). A history of cigarette smoking >10 pack years was associated with increased serum T (P<.01). A diagnosis of endometriosis was associated with decreased serum T. Serum T correlated positively with pre-hCG serum E(2) and number of oocytes retrieved. However, serum T did not significantly influence fertilization or pregnancy rates.
CONCLUSION(S): In cycling infertile women, increasing BMI and cigarette smoking are associated with increased serum T. Advancing age and endometriosis are associated with decreased serum T.
[1] 研究体重指数（BMI）、年龄、吸烟、不孕原因及口服避孕药的使用对基线血清睾酮（T）的影响；[2] 研究基线血清T与体外受精（IVF）结局之间的关联，如定期排卵女性的人绒毛膜促性腺激素（hCG）注射前血清雌二醇（E₂）、获卵数、卵母细胞受精率及妊娠结局。
前瞻性队列研究。
马萨诸塞州东部的三个IVF项目机构。
425名计划接受IVF的定期排卵女性。本研究排除了多囊卵巢综合征、排卵性不孕或月经周期不规律的女性。
收集接受IVF女性的流行病学数据和基线血清。
基线血清总T、性激素结合球蛋白（SHBG）及游离雄激素指数的计算。
体重指数>26 kg/m²与血清T显著升高（P<0.01）及游离雄激素指数显著升高（P<0.0001）相关。在整个40多岁时血清T显著下降（P<0.03）。吸烟史>10包年与血清T升高相关（P<0.01）。子宫内膜异位症的诊断与血清T降低相关。血清T与hCG注射前血清E₂及获卵数呈正相关。然而，血清T对受精率或妊娠率无显著影响。
在排卵功能障碍的不孕女性中，BMI增加和吸烟与血清T升高相关。年龄增长和子宫内膜异位症与血清T降低相关。
